An improved matrix separation method for characterization of ultrapure germanium (8N)

An improved matrix separation method has been described to characterize ultrapure germanium of 8N (99.999999%) purity. In this method, temperature of the reaction vessel in which in-situ generated chlorine gas reacts with germanium solid material directly is optimized to quantitatively remove Ge matrix from all its impurities. Optimized reaction temperature has been found to be 230±5°C. Recovery studies on more than 60 elements have been carried out at the optimized temperature. Recoveries of all the analytes except As, Se, Sn, Hg, Tl are found to be quantitative. The method has been examined for various amounts of Ge material and found to be suitable even for 10g of Ge sample and provides low parts per billion and trillion levels of process blanks. Determination of concentrations of impurities has been done by inductively coupled plasma quadrupole mass spectrometer (ICP-QMS) and high resolution continuum source graphite furnace atomic absorption spectrometer (HR-CS-GFAAS). In the absence of certified reference materials for ultrapure germanium, accuracy of the proposed method is established by spike recovery tests. Precision of this method is found to vary from 7% to 50% for concentrations between 4 and 0.004ngg(-1). Limits of detection (LOD) for the target analytes are found to be between 6 and 0.011ngmL(-1) or 1.8-0.003ngg(-1) for the proposed procedure. The method has been successfully applied for that characterization of ultrapure germanium material of 8N purity.

The SOAR stroke score predicts hospital length of stay in acute stroke: an external validation study

AIMS

The objective of this study is to externally validate the SOAR stroke score (Stroke subtype, Oxfordshire Community Stroke Project Classification, Age and prestroke modified Rankin score) in predicting hospital length of stay (LOS) following an admission for acute stroke.

METHODS

We conducted a multi-centre observational study in eight National Health Service hospital trusts in the Anglia Stroke & Heart Clinical Network between September 2008 and April 2011. The usefulness of the SOAR stroke score in predicting hospital LOS in the acute settings was examined for all stroke and then stratified by discharge status (discharged alive or died during the admission).

RESULTS

A total of 3596 patients (mean age 77 years) with first-ever or recurrent stroke (92% ischaemic) were included. Increasing LOS was observed with increasing SOAR stroke score (p < 0.001 for both mean and median) and the SOAR stroke score of 0 had the shortest mean LOS (12 ± 20 days) while the SOAR stroke score of 6 had the longest mean LOS (26 ± 28 days). Among patients who were discharged alive, increasing SOAR stroke score had a significantly higher mean and median LOS (p < 0.001 for both mean and median) and the LOS peaked among patients with score value of 6 [mean (SD) 35 ± 31 days, median (IQR) 23 (14-48) days]. For patients who died as in-patient, there was no significant difference in mean or median LOS with increasing SOAR stroke score (p = 0.68 and p = 0.79, respectively).

CONCLUSION

This external validation study confirms the usefulness of the SOAR stroke score in predicting LOS in patients with acute stroke especially in those who are likely to survive to discharge. This provides a simple prognostic score useful for clinicians, patients and service providers.

Precise measurement of the W-boson mass with the CDF II detector

We have measured the W-boson mass M(W) using data corresponding to 2.2  fb(-1) of integrated luminosity collected in pp collisions at sqrt[s] = 1.96  TeV with the CDF II detector at the Fermilab Tevatron collider. Samples consisting of 470,126 W → eν candidates and 624,708 W → μν candidates yield the measurement M(W) = 80,387 ± 12(stat.) ± 15(syst.) = 80,387 ± 19  MeV/c2. This is the most precise measurement of the W-boson mass to date and significantly exceeds the precision of all previous measurements combined.

Status of copper and magnesium levels in diabetic nephropathy cases: a case-control study from South India

Diabetic nephropathy is a complication of diabetes mellitus. This present study investigates the status of copper and magnesium in diabetic nephropathy cases to establish a possible relation. Forty patients of diabetic nephropathy participated in the study as cases. Forty age- and sex-matched healthy individuals served as controls. Blood samples were collected from both cases and controls for determination of FBS, PPBS, HbA1c, microalbumin, copper, and magnesium levels. The mean concentrations of FBS, PPBS, HbA1c, and microalbumin of cases were significantly higher than that of controls. The mean magnesium levels of cases (1.60 ± 0.32 meq/L) were significantly lower than controls 2.14 ± 0.16 meq/L (p < 0.05). But the mean copper levels of cases, 165.42 ± 5.71 μg/dl, shows no significant difference with controls, 166.6 ± 5.48 μg/dl, (p > 0.05).The findings in the present study suggest that hypomagnesemia may be linked with development of diabetic nephropathy.

Serotonin syndrome: an unusual cause of acute confusion and fever in the elderly

Delirium is a common cause for hospital admission among elderly patients. Although infection is the most common explanation, there is a large number of other potential causes. We present a case of acute delirium due to serotonin syndrome, precipitated by concomitant prescription of clarithromycin and fluoxetine. The symptoms improved following treatment with a benzodiazepine and discontinuation of the fluoxetine. The diagnosis and management of serotonin syndrome is discussed.

Improved search for a Higgs boson produced in association with Z → l+ l- in pp collisions sqrt[s] = 1.96 TeV

We search for the standard model Higgs boson produced with a Z boson in 4.1 fb(-1) of integrated luminosity collected with the CDF II detector at the Tevatron. In events consistent with the decay of the Higgs boson to a bottom-quark pair and the Z boson to electrons or muons, we set 95% credibility level upper limits on the ZH production cross section multiplied by the H → bb branching ratio. Improved analysis methods enhance signal sensitivity by 20% relative to previous searches. At a Higgs boson mass of 115 GeV/c2 we set a limit of 5.9 times the standard model cross section.

Measurement of the top-quark mass with dilepton events selected using neuroevolution at CDF

We report a measurement of the top-quark mass M_{t} in the dilepton decay channel tt[over ] --> bl;{'+} nu_{l};{'}b[over ]l;{-}nu[over ]_{l}. Events are selected with a neural network which has been directly optimized for statistical precision in top-quark mass using neuroevolution, a technique modeled on biological evolution. The top-quark mass is extracted from per-event probability densities that are formed by the convolution of leading order matrix elements and detector resolution functions. The joint probability is the product of the probability densities from 344 candidate events in 2.0 fb;{-1} of pp[over ] collisions collected with the CDF II detector, yielding a measurement of M_{t} = 171.2 +/- 2.7(stat) +/- 2.9(syst) GeV / c;{2}.

Transient global amnesia--a review

Transient global amnesia (TGA) is an isolated amnesic syndrome with normal neurological examination where patients remain alert and communicative with no loss of personal identity; however, they experience striking loss of memory for recent events and an impaired ability to retain new information. TGA could be triggered by venous congestion and there is evidence of association between younger patients and history of migraine. Most episodes last 2-12 h and the recurrence rate of future amnesic events is very low.

Effect of ultrasound probe on dose delivery during real-time ultrasound-guided tumor tracking

Ultrasound is a noninvasive and less costly modality for real-time imaging of soft tissues. It has the capability of tracking soft tissue at levels of submillimeter precision even in the presence of radiation beams. The effect of a transducer on radiation dose is not fully known. The best imaging location for an ultrasound transducer happens to coincide with the path of an anterior-posterior beam in intensity modulated radiation therapy (IMRT). This study indicates a significant change in dose when this juxtaposition occurs. If the anterior-posterior beam is avoided in IMRT planning, however, the effect of the transducer on radiotherapy is found to be negligible.

FPGA-Accelerated Deformable Image Registration for Improved Target-Delineation During CT-Guided Interventions

Minimally invasive image-guided interventions (IGIs) are time and cost efficient, minimize unintended damage to healthy tissue, and lead to faster patient recovery. With the advent of multislice computed tomography (CT), many IGIs are now being performed under volumetric CT guidance. Registering pre-and intraprocedural images for improved intraprocedural target delineation is a fundamental need in the IGI workflow. Earlier approaches to meet this need primarily employed rigid body approximation, which may not be valid because of nonrigid tissue misalignment between these images. Intensity-based automatic deformable registration is a promising option to correct for this misalignment; however, the long execution times of these algorithms have prevented their use in clinical workflow. This article presents a field-programmable gate array-based architecture for accelerated implementation of mutual information (Ml)-based deformable registration. The reported implementation reduces the execution time of MI-based deformable registration from hours to a few minutes. This work also demonstrates successful registration of abdominal intraprocedural noncontrast CT (iCT) images with preprocedural contrast-enhanced CT (preCT) and positron emission tomography (PET) images using the reported solution. The registration accuracy for this application was evaluated using 5 iCT-preCT and 5 iCT-PET image pairs. The registration accuracy of the hardware implementation is comparable with that achieved using a software implementation and is on the order of a few millimeters. This registration accuracy, coupled with the execution speed and compact implementation of the reported solution, makes it suitable for integration in the IGI-workflow.

Physically correct mesh manipulation in multi-level free-form deformation-based nonrigid registration

We present a new solution to prevent mesh folding artifacts common in free-form deformation-based nonrigid registration. Our algorithm imposes linear bounds on the search space of control point locations, thereby enabling the use of constrained optimization algorithms. We also introduce a new method for controlling the mesh rigidity, based on maximum voxel displacement. Our method allows local control of the deformation, based on a priori knowledge of the magnitude of possible local deformations.

Evaluation of three-dimensional segmentation algorithms for the identification of luminal and medial-adventitial borders in intravascular ultrasound images

Intravascular ultrasound (IVUS) provides direct depiction of coronary artery anatomy, including plaque and vessel area, which is important in quantitative studies on the progression or regression of coronary artery disease. Traditionally, these studies have relied on manual evaluation, which is laborious, time consuming, and subject to large interobserver and intraobserver variability. A new technique, called active surface segmentation, alleviates these limitations and makes strides toward routine analyses. However, for three-dimensional (3-D) plaque assessment or 3-D reconstruction to become a clinical reality, methods must be developed which can analyze many images quickly. Presented is a comparison between two active surface techniques for three-dimensional segmentation of luminal and medial-adventitial borders. The force-acceleration technique and the neighborhood-search technique accurately detected both borders in vivo (r2 = 0.95 and 0.99, Williams' index = 0.67 and 0.65, and r2 = 0.95 and 0.99, WI = 0.67 and 0.70, respectively). However, the neighborhood-search technique was significantly faster and required less computation. Volume calculations for both techniques (r2 = 0.99 and r2 = 0.99) also agreed with a known-volume phantom. Active surface segmentation allows 3-D assessment of coronary morphology and further developments with this technology will provide clinical analysis tools.

Three-dimensional reconstruction of the coronary artery wall by image fusion of intravascular ultrasound and bi-plane angiography

BACKGROUND

Intravascular ultrasound (IVUS) is becoming increasingly accepted for assessing coronary anatomy. However, its utility in visualizing and quantifying coronary morphology has been limited by its 2D tomographic nature. This study presents a 3D reconstruction technique that accurately preserves 3D geometric information.

METHODS AND RESULTS

Images obtained from manual IVUS pullbacks and continuous bi-plane angiography were fused, using angiography to reconstruct the transducer trajectory and aid in solving for the correct rotational orientation. A novel 3D active surface method automatically identified the luminal and medial-adventitial borders which, when superimposed on the transducer trajectory, could be surface-rendered for visualization and morphometry. Segmentation agreed well with manual assessment, and 3D luminal shape matched that of angiography when projected to 2D.

CONCLUSIONS

We conclude that this method provides an accurate reconstruction of the vessel's anatomy, which accounts for the true curvature of the vessel.

Assessment of coronary compensatory enlargement by three-dimensional intravascular ultrasound

Several techniques have been used to demonstrate that human arteries respond to atherosclerosis by increasing their total arterial area to prevent a decrease in blood flow. Three-dimensional reconstructions of coronary arteries can document this compensatory response accurately and specifically. Seven human coronary arteries were reconstructed using intravascular ultrasound and biplane angiography, and vessel geometries were quantified. In all seven vessels, as plaque area increased, overall vessel area increased (R = 0.986, 0.933, 0.984, 0.678, 0.763, 0.963, and 0.830), but luminal cross-sectional area did not significantly decrease. Focal compensatory enlargement was identified in each vessel, and in some cases this response appeared to occur until the vessel was 65% occluded. Luminal enlargement near the proximal ends was attributed to the natural taper of the vessel. The semi-automated, three-dimensional segmentation technique used in this study allows reproducible quantification, as there is no subjective manual tracing involved. Following the intravascular ultrasound transducer in time and space with biplane angiography allows for accurate reconstruction with or without automated pullback devices. Information on the rate of change of vessel measurements is also presented, which, when combined with visualization of accurate 3D geometry, provides a unique assessment of coronary compensatory enlargement. This reconstruction technique can be applied in a clinical environment with no major modification.

Three-dimensional segmentation of luminal and adventitial borders in serial intravascular ultrasound images

Intravascular ultrasound (IVUS) provides exact anatomy of arteries, allowing accurate quantitative analysis. Automated segmentation of IVUS images is a prerequisite for routine quantitative analyses. We present a new three-dimensional (3D) segmentation technique, called active surface segmentation, which detects luminal and adventitial borders in IVUS pullback examinations of coronary arteries. The technique was validated against expert tracings by computing correlation coefficients (range 0.83-0.97) and William's index values (range 0.37-0.66). The technique was statistically accurate, robust to image artifacts, and capable of segmenting a large number of images rapidly. Active surface segmentation enabled geometrically accurate 3D reconstruction and visualization of coronary arteries and volumetric measurements.